title: The development of the tobacco tactics website.
abstract: BACKGROUND
  Web-based cessation interventions have been shown to reduce tobacco use, be more efficacious than self-help booklets, be more efficacious if they provide tailored messages, and enhance quit rates in conjunction with nicotine replacement therapy.
  
  
  OBJECTIVE
  The objective of this study was to usability test and pilot test the Tobacco Tactics website for veterans.
  
  
  METHODS
  Both formative and summative evaluations were used across three small successive studies to develop and test the Tobacco Tactics website for veterans, which was based on a prior face-to-face smoking cessation intervention. Once the website was developed, the research team and Web developers usability tested the website with 5 veteran smokers and former smokers. Feedback from the veterans was collected as they navigated each webpage, then used to revise the website. In pilot study 1, 9 veteran smokers were provided access to the website, and given a baseline and 30-day follow-up survey. In pilot study 2, 18 veteran smokers, who were also motivated to quit smoking, were recruited and randomized to either the Tobacco Tactics website plus nicotine replacement therapy or to the 1-800-QUIT-NOW telephone line.
  
  
  RESULTS
  As a result of usability testing, more than 27 modifications were made to improve the website. In pilot study 1, 50% (3/6) veterans who entered the website had cut down on the number of cigarettes and 83% (5/6) found the website enjoyable, easy to read, easy to navigate, and would recommend the website to others. In pilot study 2, which included only smokers motivated to quit and also offered nicotine replacement therapy, seven-day point prevalence abstinence at 30-day follow-up was 40% (4/10) in the intervention group compared to 13% (1/8) in the control group.
  
  
  CONCLUSIONS
  These preliminary results are promising and suggest the need for wider-scale testing of the Tobacco Tactics website for veterans.
authors.affiliation: Veterans Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, United States. bump@umich.edu.
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Duffy
authors.forename: Karen E
authors.initials: KE
authors.lastname: Fowler
authors.forename: Petra S
authors.initials: PS
authors.lastname: Flanagan
authors.forename: David L
authors.initials: DL
authors.lastname: Ronis
authors.forename: Lee A
authors.initials: LA
authors.lastname: Ewing
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Waltje
keywords: Internet; health services accessibility; intervention studies; smoking cessation